| NPI | 1124741798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS019726) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2020031714) |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2022-11-16 |