| NPI | 1972176063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 8.004412) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY11143) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2024-05-21 |