| NPI | 1295190320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS018505) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MO 2015040309) |
| 103TC0700X Psychologist Clinical (Licence: KS LP2364) | |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2022-09-19 |