| NPI | 1609873884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN TNP0000001198) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: TN TNRN0000028104) |
| 103TC0700X Psychologist, Clinical (Licence: MN MDGL0004) | |
| 103TC0700X Psychologist, Clinical (Licence: TN P0000001198) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2011-08-24 |