| NPI | 1053179861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 109609) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NE 1123) |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2025-09-30 |