| NPI | 1518965730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN P2740) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN PT764) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2019-01-18 |