| NPI | 1871354571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 07032) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS007376L) |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-01-19 |