| NPI | 1699936591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PSO17352) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY6023) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2024-05-23 |