| NPI | 1083235105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 3507) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 38481) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2022-04-26 |