| NPI | 1770040578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38713) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: LA 1637) |
| 103TF0200X Psychologist, Forensic (Licence: CO PSY.0005808) | |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2022-08-11 |