| NPI | 1881930899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 4799) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2016035608) |
| 103TC0700X Psychologist, Clinical (Licence: UT 9259127-2501) | |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2022-01-27 |