| NPI | 1245595776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 001325) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 2677) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2020-11-08 |