| NPI | 1184253957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810008266) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2023-10-18 |