| NPI | 1417627134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3814) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: OR 105462) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2024-09-24 |