| NPI | 1104869320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: SC 1043) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 1043) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2018-02-28 |