| NPI | 1346623576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810005119) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 05524) |
| 103TC0700X Psychologist Clinical (Licence: DC PSY1001033) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |