| NPI | 1548636723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-004650) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4650) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2018-11-07 |