| NPI | 1750419289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3049) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 21122) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2021-04-09 |