| NPI | 1053790964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016108) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DE B1-0000766) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |