| NPI | 1588199970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 4415) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: RI PS02064) |
| 103T00000X Psychologist (Licence: CO 4415) | |
| 103TF0000X Psychologist Family (Licence: OH 4415) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: CO 4415) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: CO 4415) | |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2023-06-28 |