| NPI | 1568523785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 1195) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2002030472) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2017-03-27 |