| NPI | 1215331202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5525) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WY 552) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2025-06-30 |