| NPI | 1962447797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 2751) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: CO 0310366) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2024-08-18 |