| NPI | 1851039481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 171W00000X Contractor | |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2022-05-26 |