| NPI | 1235299199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO PSY.0003872) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO CO3872) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2019-04-17 |