| NPI | 1346604964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05405) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC PSY1001018) |
| Enumeration Date | 2016-04-09 |
| Last Update Date | 2019-01-23 |