| NPI | 1629438387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: VA 0810005361) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: VA 0810005361) |
| 103TC0700X Psychologist Clinical (Licence: VA 0810005361) | |
| 103TF0000X Psychologist Family (Licence: VA 0810005361) | |
| 103TF0200X Psychologist Forensic (Licence: VA 0810005361) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: VA 0810005361) | |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2018-09-10 |