| NPI | 1669712857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004504) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 04903) |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2016-06-11 |