| NPI | 1568861615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: VA 0813001078) |
| Additional Taxonomies | 251C00000X (Licence: VA 0133000330) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2020-09-08 |