| NPI | 1801445952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TE1100X Psychologist, Exercise & Sports |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 2068) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2021-07-16 |