| NPI | 1518467901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS 581018) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810005860) |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2018-02-13 |