| NPI | 1053884312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: LA 1510) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AL 2114) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2019-08-07 |