| NPI | 1750046017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 6274) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL 9892) |
| 103TC0700X Psychologist, Clinical (Licence: GA 002648) | |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2025-10-14 |