| NPI | 1538421474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY11138) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS018139) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2021-09-17 |