| NPI | 1992154801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 05257) |
| Additional Taxonomies | 103TF0200X Psychologist Forensic |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2016-09-14 |