| NPI | 1295126571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY0004212) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WY 558) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2015-11-18 |