| NPI | 1245473305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 6530) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: PR 9176) |
| Enumeration Date | 2009-04-19 |
| Last Update Date | 2021-04-09 |