| NPI | 1578178976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: OR 162433) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: FL 1100153) |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2020-09-11 |