| NPI | 1861557654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 1189) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CO PSY.0001189) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2023-12-04 |