| NPI | 1316542566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist Health Service |
| Additional Taxonomies | 103TH0004X Psychologist Health |
| 103TH0100X Psychologist Health Service | |
| 251E00000X Home Health | |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2020-12-03 |