| NPI | 1710969423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 8914) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810003233) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2022-09-23 |