| NPI | 1417500414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5762) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: NC 5762) | |
| 103TH0100X Psychologist, Health Service | |
| 103TH0100X Psychologist, Health Service (Licence: NC 5762) | |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2021-01-26 |