| NPI | 1245682145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: VA 0904009511) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904009511) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2016-07-05 |