| NPI | 1629858675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 12054) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY12054) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2025-03-20 |