| NPI | 1205384708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 4972) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VT 048.0098908) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2018-06-04 |