| NPI | 1881192011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL 10989) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 081005935) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2020-12-29 |