| NPI | 1033800453 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TH0100X Psychologist, Health Service | 
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) | 
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2023-05-17 | 
| Last Update Date | 2025-09-18 |