| NPI | 1326783911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MT 3789) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MT 3789) |
| 103TC0700X Psychologist Clinical (Licence: MT 3789) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MT 3789) | |
| 103TH0100X Psychologist Health Service (Licence: MT 3789) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MT 3789) | |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-04-28 |