| NPI | 1801387311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005857) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY9475) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-05-21 |