| NPI | 1659452423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810003380) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 04616) |
| 103TC0700X Psychologist Clinical (Licence: DC PSY100330) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2015-12-22 |