| NPI | 1942300546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 4234) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 20069) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2017-02-19 |