| NPI | 1720117781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006200) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2019-09-05 |