| NPI | 1457805160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 4698) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 4846) |
| 103T00000X Psychologist (Licence: CO 4698) | |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2018-04-03 |