| NPI | 1003294232 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 06162)  | 
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: MD 06162)  | 
| Enumeration Date | 2015-05-07 | 
| Last Update Date | 2019-06-10 |