| NPI | 1225262678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810003868) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 34395) |
| 103T00000X Psychologist (Licence: TX 34395) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2019-02-06 |