| NPI | 1023655362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: WI 3742-57) |
| 103TC0700X Psychologist Clinical (Licence: WI 3742-57) | |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2022-12-07 |