| NPI | 1205017852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: SC 7393) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: SC 1373) |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2023-03-24 |