| NPI | 1477659290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NE 069) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NE 69) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2025-04-02 |