| NPI | 1124308143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MD 05080) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810003098) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2020-09-21 |