| NPI | 1790752517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: LA 1646) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 7380) |
| 103T00000X Psychologist (Licence: NC 4732) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2024-10-23 |