| NPI | 1649258583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 2572) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 7260) |
| Enumeration Date | 2005-12-31 |
| Last Update Date | 2022-11-03 |