| NPI | 1225676802 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: DC PSY1001529) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 06115) | 
| Enumeration Date | 2019-12-14 | 
| Last Update Date | 2019-12-14 |