| NPI | 1558789925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2018017437) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 03033) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-12-10 |