| NPI | 1093279655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810007823) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY10352) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2024-06-17 |