| NPI | 1063035541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-005185) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ PSY-005185) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2021-07-05 |