| NPI | 1134237787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9111) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 205032795) |
| 103T00000X Psychologist (Licence: NH 1133) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-10-30 |