| NPI | 1508213158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005436) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 5096) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2021-10-13 |