| NPI | 1649375619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN P0000001528) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MS 31-455) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2017-04-30 |