| NPI | 1396042008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 109350) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 05196) |
| 103TC0700X Psychologist, Clinical (Licence: MN LP6527) | |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2024-05-01 |