| NPI | 1093481822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY12981) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 007216) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2025-10-07 |