| NPI | 1316296650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 005481) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: UT 8791112-2501) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2024-07-05 |