| NPI | 1538422563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NV PY0648) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO PSY.0005500) |
| 103TC0700X Psychologist, Clinical (Licence: NV PY0648) | |
| 103TC0700X Psychologist, Clinical (Licence: CO PSY.0005500) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NV PY0648) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CO PSY.0005500) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2021-07-12 |