| NPI | 1154966299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: TN 3687) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TN 3687) |
| 103TH0100X Psychologist Health Service (Licence: TN 3687) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: TN 3687) | |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2023-09-23 |