| NPI | 1023290459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 39396) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103T00000X Psychologist (Licence: FL PY8304) | |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2023-08-08 |