| NPI | 1720433774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN P0000003182) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 7883) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |