| NPI | 1497344360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN 3658) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: SC 1566) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2021-12-22 |