| NPI | 1619539947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ID 203634) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: ID PSY-203634) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2025-08-08 |