| NPI | 1154744159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36871) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01426) |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2015-09-14 |