| NPI | 1811488869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 1374) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 1374) |
| 103TC1900X Psychologist Counseling (Licence: SC 1374) | |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2022-04-19 |