| NPI | 1982254215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: RI PS01805) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WA PY60391362) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-12-26 |