| NPI | 1770728180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ND 611) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC NC 3363) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2023-12-28 |