| NPI | 1124129077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: OK 586) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OK 586) |
| 103TC0700X Psychologist Clinical (Licence: OK 586) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TN P2174) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OK 586) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: TN P2174) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: OK 586) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2021-07-08 |