| NPI | 1902278864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 1696) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NC 1696) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NC 1696) | |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2015-10-30 |