| NPI | 1740384114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO PSY2080) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CO 2080) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2018-08-14 |