| NPI | 1619332293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 04579) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810004062) |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2022-02-15 |