| NPI | 1508068339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 9575) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 9575) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-09-23 |