| NPI | 1275641664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 4038) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 4038) |
| 103TC0700X Psychologist, Clinical (Licence: NC 1388) | |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2021-01-19 |