| NPI | 1104173442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 0) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 4273) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2019-02-28 |