| NPI | 1902246010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3072) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA 61425975) |
| 103TC0700X Psychologist, Clinical (Licence: NY 021321) | |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2024-04-22 |