| NPI | 1700811015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2598-057) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ PSY-005478) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2026-03-29 |