| NPI | 1104973890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 2612) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 2612) |
| 103TS0200X Psychologist, School (Licence: NC 2612) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-09-08 |