| NPI | 1174592380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 4292) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC 2868) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2017-11-26 |