| NPI | 1083168041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071.009432) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IL 180009177) |
| 103T00000X Psychologist (Licence: WI 3415 - 57) | |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2021-02-17 |