| NPI | 1164933123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071010263) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166001364) |
| 103TC0700X Psychologist, Clinical (Licence: WI 3960-57) | |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2021-06-15 |