| NPI | 1124173133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2176057) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 2176-57) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2023-03-15 |