| NPI | 1538178116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 61219) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 2695) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2019-07-26 |