| NPI | 1811055494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 6358) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2023-06-21 |