| NPI | 1174800528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017824) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS T-LP 2008) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2018-03-17 |