| NPI | 1265086227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS018166) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TC0700X Psychologist Clinical (Licence: PA PS018166) | |
| 103TF0200X Psychologist Forensic (Licence: PA PS018166) | |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2019-07-29 |