| NPI | 1992177547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810008239) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA 33590) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2023-10-09 |