| NPI | 1750733564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3149) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: NC 3149) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2022-07-21 |