| NPI | 1114470721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IA 122860) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OR 3114) |
| Enumeration Date | 2016-07-31 |
| Last Update Date | 2024-07-16 |