| NPI | 1114347846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1399) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 35083) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2020-01-08 |