| NPI | 1467847764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 6622) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO PSY.005380) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2024-09-02 |