| NPI | 1770767428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 114176) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AR 12-019) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2023-11-09 |