| NPI | 1184254559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 06264) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810006296) |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2020-01-24 |