| NPI | 1104479476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5504) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 5504) |
| 103TC0700X Psychologist, Clinical (Licence: NC 5504) | |
| 103TC1900X Psychologist, Counseling (Licence: NC 5504) | |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-16 |