| NPI | 1639872625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VT 048.0134749) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS019799) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-03-27 |