| NPI | 1164461216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 2734) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-TL-0400) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-01-12 |