| NPI | 1255490579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 839) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: LA MP.000839) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: LA 839) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2021-11-04 |