| NPI | 1104549252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 555875) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AL LMO01129873) |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2022-09-23 |