| NPI | 1689655128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: KS LP 1152) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KS LP 1152) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2022-10-26 |