| NPI | 1639318819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 3278) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY11065) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2023-01-04 |