| NPI | 1942678883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04976) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: DC 1000570) | |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810004181) | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2024-01-04 |