| NPI | 1396451464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 5608) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: AZ 5608) |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-01-23 |