| NPI | 1457597767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AK 635) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OR 628) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2019-03-14 |