| NPI | 1417002403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 546) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 546) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2019-09-28 |