| NPI | 1184802241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 3881) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NC 3881) |
| 103T00000X Psychologist (Licence: NC 3881) | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2021-12-27 |