| NPI | 1871765941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 9128) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 8697) |
| Enumeration Date | 2008-03-29 |
| Last Update Date | 2018-09-26 |