| NPI | 1366892853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY 170541) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IN 20042956A) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2017-02-21 |