| NPI | 1619105582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO PSY3783) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY7756) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2024-06-18 |