| NPI | 1982050282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 05802) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: DC PSYA00078) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2017-05-15 |