| NPI | 1487099198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810005636) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 05280) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2022-03-24 |