| NPI | 1144256637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 2102) |
| Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy (Licence: NC 2102) |
| 103TF0000X Psychologist Family (Licence: NC 2102) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NC 2102) | |
| 103TA0700X Psychologist Adult Development & Aging (Licence: NC 2102) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 2102) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2021-01-17 |