| NPI | 1962888388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2595) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OR 2595) |
| 103TC0700X Psychologist, Clinical (Licence: OR 2595) | |
| 103TH0004X Psychologist, Health (Licence: OR 2595) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: OR 2595) | |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2020-03-05 |