| NPI | 1053412510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: VA 0803000189) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WV 846) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2025-09-11 |