| NPI | 1619492543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 4877) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4877) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: AZ 4877) | |
| 103TF0000X Psychologist Family (Licence: AZ 4877) | |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2017-08-11 |