| NPI | 1912432303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 0004532) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO Psy0004532) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2020-03-13 |