| NPI | 1235513011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 3951) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: IA 077389) |
| Enumeration Date | 2015-07-12 |
| Last Update Date | 2025-05-22 |