| NPI | 1235553686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 1858) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2014001576) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2014-05-07 |