| NPI | 1770713778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MT 1478) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 4031) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2019-12-09 |