| NPI | 1689073686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04791) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 081004691) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2014-08-15 |