| NPI | 1376155606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: UT 11455930-2501) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: UT 11455930-2501) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |