| NPI | 1013767292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY12264) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP6977) |
| Enumeration Date | 2024-03-22 |
| Last Update Date | 2024-10-14 |