| NPI | 1184271363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 4255) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 17121) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |