| NPI | 1629793542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: PR 3650) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: PR 3650) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PR 3650) | |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |