| NPI | 1568588408 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ PSY004733)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4733)  | 
| Enumeration Date | 2007-03-22 | 
| Last Update Date | 2022-02-17 |