| NPI | 1639371479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10098) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS LP03030) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2023-03-03 |