| NPI | 1467473611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 805) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO py01506) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2021-01-11 |