| NPI | 1609899160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY0005420) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS003371L) |
| 103TC0700X Psychologist, Clinical (Licence: MA 2971) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-01-05 |