| NPI | 1659694974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MO 2011032874) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 0712010118186) |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2023-11-07 |