| NPI | 1609428168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 5608) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: NC 5608) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2022-03-25 |