| NPI | 1528650603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS018230) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: DE B1-0001078) |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2021-02-09 |