| NPI | 1780122739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 3403) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 3403-57) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2018-09-20 |