| NPI | 1558453647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ PSY-005500) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS 004641 L) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2022-06-08 |