| NPI | 1447500087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 4564) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC NOT ISSUED YET) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2022-07-23 |