| NPI | 1316052756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NM 749) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ID PSY-361) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2023-08-15 |