| NPI | 1659792299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MT 1333) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MT 1333) |
| Enumeration Date | 2013-12-29 |
| Last Update Date | 2016-06-07 |