| NPI | 1861674962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 1647) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2007028983) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2020-09-23 |