| NPI | 1295131969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 4572) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ PSY00-4572) |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2021-03-15 |