| NPI | 1639198153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 3884) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810003069) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-02-16 |