| NPI | 1962726679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 3221) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NH 1327) |
| 103TC0700X Psychologist, Clinical (Licence: VT 048.0058106) | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2021-09-28 |