| NPI | 1740510528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NM 4304) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC 4304) |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2018-06-05 |