| NPI | 1013108695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3523) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 4006) |
| 103TC0700X Psychologist, Clinical (Licence: UT 4793704-2501) | |
| 1041C0700X Social Worker, Clinical (Licence: UT 4793704-3501) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2018-02-20 |