| NPI | 1760633119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN 2843) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 11032) |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2022-03-07 |