| NPI | 1427217991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 3702) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC 3062) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2023-02-11 |