| NPI | 1821345364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11786) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 3544) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810005762) | |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2022-11-02 |