| NPI | 1952401051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 1027) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 1027) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2021-04-16 |