| NPI | 1326449802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 4557) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS017630) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2024-04-22 |