| NPI | 1659711026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS016681) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WV 1376) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2025-06-16 |