| NPI | 1073247136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: VA 0803000291) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0803000291) |
| 103T00000X Psychologist (Licence: SC 1742) | |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2024-02-09 |