| NPI | 1124037338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WI 2206-057) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: LA 1216) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-09-21 |