| NPI | 1922395730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1875) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 34158) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2016-02-17 |