| NPI | 1053004218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 6261) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: NC 6261) |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2023-09-12 |