| NPI | 1134601891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1477) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WY 644) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-11-14 |