| NPI | 1366979619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 01654) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MD 01654) |
| 103TH0100X Psychologist Health Service (Licence: MD 01654) | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2022-07-21 |