| NPI | 1376945535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 06612) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 37561) |
| 103TC0700X Psychologist Clinical (Licence: DC PSY1001350) | |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2021-08-24 |