| NPI | 1790106193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0003961) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN P0000003446) |
| 103TC0700X Psychologist, Clinical (Licence: WA PY00003666) | |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2022-07-21 |