| NPI | 1366848293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO PSY.0004169) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 05334) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2020-04-13 |