| NPI | 1598029589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 4254) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4254) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: AZ 4254) | |
| 103TC1900X Psychologist Counseling (Licence: AZ 4254) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: AZ 4254) | |
| 103TA0700X Psychologist Adult Development & Aging (Licence: AZ 4254) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2012-07-25 |