| NPI | 1467410423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 3206) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OH 5619) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2021-03-31 |