| NPI | 1376791103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 4989) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 29369) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2021-03-29 |