| NPI | 1790907095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 2484) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 2484) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2019-04-01 |