| NPI | 1578180154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10711) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS018953) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2021-01-04 |