| NPI | 1306242557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: UT 10098818-2501) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2022-07-21 |