| NPI | 1659878411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 002348) |
| Additional Taxonomies | 103TF0000X Psychologist Family (Licence: CT 002348) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |