| NPI | 1164060596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSY1001351) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 37553) |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |