| NPI | 1407204860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 2400) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2006036651) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |