| NPI | 1730713868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY11506) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSY0005320) |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2022-10-05 |