| NPI | 1174531610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS015540) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WI 2597-057) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2025-08-13 |