| NPI | 1801852496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38398) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: RI PS00574) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2020-07-13 |