| NPI | 1710268685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MO 2017008027) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist Clinical (Licence: CA 28028) | |
| 103TC0700X Psychologist Clinical (Licence: AZ 4597) | |
| 103TC0700X Psychologist Clinical (Licence: IA 001237) | |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2022-08-27 |