| NPI | 1265583702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2975) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 1801) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-09-25 |