| NPI | 1659456572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3591) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY003867) |
| 103TC0700X Psychologist, Clinical (Licence: MA 3241) | |
| 103TC0700X Psychologist, Clinical (Licence: MO R0224) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2017-04-18 |