| NPI | 1174811426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9167) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: MA 9167) |
| 103TH0100X Psychologist, Health Service (Licence: MA 9167) | |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2022-07-10 |