| NPI | 1053474650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SD 569) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY002609) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2018-11-07 |