| NPI | 1245674431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MT 2206) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OR 2342) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2024-02-08 |