| NPI | 1508868589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 1285) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 0005631) |
| 103T00000X Psychologist (Licence: CA 21854) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2024-08-27 |