| NPI | 1497846158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810001708) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 081001708) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2018-09-11 |