| NPI | 1548630585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301017114) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071009130) |
| 103TC0700X Psychologist Clinical (Licence: CA 28131) | |
| Enumeration Date | 2015-10-02 |
| Last Update Date | 2020-03-26 |