| NPI | 1164753539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0002136) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 2136) |
| Enumeration Date | 2010-01-24 |
| Last Update Date | 2022-08-02 |