| NPI | 1548423833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 241891) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 24703) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2019-05-04 |