| NPI | 1104305218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 06921) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810006276) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2023-09-01 |