| NPI | 1033157680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810003374) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CT 002560) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-01-28 |