| NPI | 1346781200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 2094) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 1379) |
| Enumeration Date | 2017-03-12 |
| Last Update Date | 2017-03-12 |