| NPI | 1639475387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4593) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2018-04-25 |