| NPI | 1235432832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 2614) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS017624) |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2018-01-26 |