| NPI | 1255614434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ID PSY-202880) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TC0700X Psychologist Clinical (Licence: CO PENDING APPROVAL) | |
| 103TH0100X Psychologist Health Service | |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2021-08-11 |