| NPI | 1063102358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 103525) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC 103525) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2024-07-11 |