| NPI | 1164848388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AK 157805) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 2357) |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2021-01-12 |