| NPI | 1497147193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MT MT-2524) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSYC.00013583) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2018-06-18 |