| NPI | 1407157431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-005625) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 3060) |
| 103TC0700X Psychologist, Clinical (Licence: MN LP5909) | |
| 103TC0700X Psychologist, Clinical (Licence: WI 3060) | |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2023-10-03 |