| NPI | 1205174356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017331) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2015029570) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2022-07-21 |