| NPI | 1700586138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL 11791) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL 11791) |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-10-26 |