| NPI | 1891091179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL 10402) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PR 3898) |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2023-11-24 |