| NPI | 1275929630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2559) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1716) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-05-13 |