| NPI | 1104166768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 4128) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PR 4128) |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2022-09-14 |