| NPI | 1225383078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC 1167) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA 0003505) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2023-05-09 |