| NPI | 1477957512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: DC PSY1001001) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11264) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2020-03-20 |