| NPI | 1023388618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 1473) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 1473) |
| 103TC1900X Psychologist, Counseling (Licence: NC 1473) | |
| 103TF0000X Psychologist, Family (Licence: NC 1473) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC 1473) | |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2022-07-21 |