| NPI | 1720192321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VT VT661) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY6126) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2015-03-06 |