| NPI | 1639267016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 003632) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VT 675) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-03-08 |