| NPI | 1083988414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WY 511) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810007635) |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2023-02-15 |