| NPI | 1548637457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WY 561) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WY 561) |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2018-09-25 |