| NPI | 1568945392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA 4808) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 37931) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2025-07-28 |