| NPI | 1215689773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS019449) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810007307) |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-25 |