| NPI | 1891856860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ND 513) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TN 2616) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2015-09-03 |