| NPI | 1023573789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY10360) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: FL PY10360) |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2021-11-30 |