| NPI | 1871802314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810006183) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2019-06-05 |