| NPI | 1366561722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: DC 1768) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD PSY03083) |
| 103TC0700X Psychologist Clinical (Licence: MD 03083) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2024-04-09 |