| NPI | 1750405759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 2469) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 004160) |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2023-06-05 |