| NPI | 1164882411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NM PSY1553) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AK 105062) |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2019-08-20 |