| NPI | 1093707044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 19360) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 1694-057) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2025-10-14 |