| NPI | 1487892014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810003370) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 8990) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2019-05-16 |