| NPI | 1205182987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NE 875) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2012012457) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2021-05-17 |