| NPI | 1396942611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NM PSY1540) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: HI PSY1108) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2023-12-11 |