| NPI | 1184163339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 4816) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 4816) |
| 103TF0200X Psychologist, Forensic (Licence: AZ 4816) | |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-02-21 |