| NPI | 1689658072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 1679) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 1679) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2025-07-09 |