| NPI | 1568989036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 2862) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 2862) |
| 103TC1900X Psychologist, Counseling (Licence: CO 2862) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CO 2862) | |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2022-07-21 |