| NPI | 1104060771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3577) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: NC 026) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2021-11-23 |