| NPI | 1700431152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810008438) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 36776) |
| 103TC0700X Psychologist, Clinical (Licence: TX 36776) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 36776) | |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2024-05-06 |