| NPI | 1720853963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WY 771) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 22269) |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2023-11-17 |