| NPI | 1215062823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 756) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: SC 756) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: SC 756) | |
| 103TH0100X Psychologist Health Service (Licence: SC 756) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2022-07-21 |