| NPI | 1003258716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5463) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004839) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2021-04-01 |