| NPI | 1609266014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 3409) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 3409) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-01-23 |