| NPI | 1821434994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS018021) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 10343) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2018-07-06 |