| NPI | 1902159031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 2112) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS TLP-2112) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2019-03-16 |