| NPI | 1043631047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017795) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: RI PS01421) |
| 103TH0100X Psychologist, Health Service (Licence: RI PS01421) | |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2021-05-21 |