| NPI | 1205494200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04914) |
| Additional Taxonomies | 103TS0200X Psychologist, School |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-12-09 |