| NPI | 1073859211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 05649) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810004666) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2025-08-25 |