| NPI | 1144829466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2020035053) |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-12-16 |