| NPI | 1740796333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 12449) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 0006643) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2025-01-09 |