| NPI | 1023680675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 6436) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810008144) |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2023-10-05 |