| NPI | 1659790947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810005304) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 05311) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810005304) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2021-02-26 |