| NPI | 1053674143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: 4605) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: SC 4605) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2025-02-06 |