| NPI | 1164062782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.010024) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY10320) |
| 103TC0700X Psychologist, Clinical (Licence: WI 4065-57) | |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2024-10-22 |