| NPI | 1073533915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 1406) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 1406) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2021-04-08 |