| NPI | 1336548957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9760) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS02352) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2026-07-15 |