| NPI | 1568931756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS018489) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: PA PS018489) |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2018-11-16 |