| NPI | 1578658522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE B10000237) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS005845L Inactive) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071.003124) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-04-11 |