| NPI | 1154493393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KS 1713) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2006029907) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2021-12-02 |