| NPI | 1598214066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 5299) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AZ 4840) |
| 103TC0700X Psychologist Clinical (Licence: SD 547) | |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2023-02-17 |