| NPI | 1972598993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: SD 405) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IA 835) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2023-08-03 |