| NPI | 1235626565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4208) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: AZ 4208) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |