| NPI | 1205254562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10491) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 3763) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2026-06-16 |