| NPI | 1871156232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 06035) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 06035) |
| 103TC0700X Psychologist Clinical (Licence: VA 0810006256) | |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2020-09-04 |