| NPI | 1982718623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2005028850) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2005028850) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2021-07-26 |