| NPI | 1912290552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AL 1684) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: AL 1684) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: AL 1684) | |
| 103TP0814X Psychologist Psychoanalysis (Licence: AL 1684) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: AL 1684) | |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2011-05-16 |