| NPI | 1538582903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2509) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: UT 8833744-2501) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2019-05-22 |