| NPI | 1609200252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: OR 2683) |
| 103TS0200X Psychologist School | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2023-06-21 |