| NPI | 1164959219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 85839) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 4516) |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2022-07-21 |