| NPI | 1427447929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810005619) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 05389) |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2021-08-13 |