| NPI | 1659745958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810003313) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: DC PSY1000102) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2015-11-24 |