| NPI | 1851717276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PR 005214) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PR 005214) |
| 103TF0000X Psychologist, Family (Licence: PR 005214) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PR 005214) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: PR 005214) | |
| 103TS0200X Psychologist, School (Licence: PR 005214) | |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2014-03-10 |