| NPI | 1396065587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5592) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 4489) |
| 103TC0700X Psychologist, Clinical (Licence: CO 3453) | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2019-09-24 |