| NPI | 1669710679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 3915) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: PA PS017341) |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2020-02-10 |