| NPI | 1568741841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810004442) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA 016169) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2023-05-08 |