| NPI | 1215385273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 1889) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: PR 1889) |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: PR 1889) | |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |