| NPI | 1104407642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: LA 1571) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 38519) |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-04-16 |