| NPI | 1689218828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 103250) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 103250) |
| 103TH0004X Psychologist Health (Licence: NC 103250) | |
| 103TH0100X Psychologist Health Service (Licence: NC 103250) | |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2020-08-14 |