| NPI | 1386312643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 6211) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| 103TE1100X Psychologist Exercise & Sports | |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2022-09-27 |