| NPI | 1811225337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 4772) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AZ UNKNOWN) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2021-01-11 |