| NPI | 1639424930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: FL 8416) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: KS 2029) |
| 103TE1100X Psychologist, Exercise & Sports (Licence: KS 2029) | |
| 103TE1100X Psychologist, Exercise & Sports (Licence: FL 8416) | |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2022-07-21 |