| NPI | 1659981256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 31065) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 33208) |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2020-08-07 |