| NPI | 1205493640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: KS LP03171) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: KS 02991-T) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2022-11-15 |