| NPI | 1821404252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004995) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: VA 0810004995) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: VA 0810004995) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-28 |