| NPI | 1215669148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810007711) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: VA 0810007711) |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2025-08-31 |