| NPI | 1639403116 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS-009160-L) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS009160L) | 
| Enumeration Date | 2009-09-30 | 
| Last Update Date | 2023-02-24 |