| NPI | 1700144466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3587) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004579) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2021-02-16 |