| NPI | 1578905717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 002194) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: CT 002194) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-07-29 |