| NPI | 1093373631 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3175) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR TBD) | 
| 103TH0004X Psychologist, Health (Licence: OR TBD) | |
| 103TH0100X Psychologist, Health Service (Licence: OR TBD) | |
| Enumeration Date | 2019-05-29 | 
| Last Update Date | 2025-01-17 |