| NPI | 1124323118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2156) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 9838) |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2025-01-16 |