| NPI | 1407267537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2018019557) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810005553) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2020-08-05 |