| NPI | 1477191393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810007494) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS018790) |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2021-08-03 |