| NPI | 1295140077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810005445) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 5059) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2017-09-13 |