| NPI | 1821102690 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: CT 001993) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 001993) | 
| Enumeration Date | 2006-08-18 | 
| Last Update Date | 2018-05-21 |