| NPI | 1912282526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005596) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AL 1679) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2023-03-31 |