| NPI | 1114177003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810004621) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: DC 05304) |
| 103TC0700X Psychologist Clinical (Licence: MD PSY1000829) | |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2017-07-20 |