| NPI | 1225447543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 5449) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY10203) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2019-03-01 |