| NPI | 1023443744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 6328) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS019859) |
| 103TC0700X Psychologist, Clinical (Licence: NY 020141) | |
| 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00545000) | |
| 103TE1100X Psychologist, Exercise & Sports (Licence: NC 6328) | |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2024-03-17 |