| NPI | 1699374843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS018412) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PA PS018412) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PA PS018412) | |
| 103TC1900X Psychologist, Counseling (Licence: PA PS018412) | |
| 103TF0200X Psychologist, Forensic (Licence: PA PS018412) | |
| 103TC0700X Psychologist, Clinical (Licence: PA PS018412) | |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2023-08-31 |