| NPI | 1114208576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KS LCP1450) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KS T-LMLP 1395) |
| 103TC0700X Psychologist Clinical (Licence: KS LMLP2436) | |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2022-07-21 |