| NPI | 1902014624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO PSY.0003825) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS006056L) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2013-10-02 |