| NPI | 1093373631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR TBD) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: OR TBD) |
| 103TH0100X Psychologist, Health Service (Licence: OR TBD) | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |