| NPI | 1578223756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: RI 559) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA 14042) |
| Enumeration Date | 2021-12-29 |
| Last Update Date | 2021-12-29 |