| NPI | 1760587323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 048.0134642) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 2051) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-01-08 |