| NPI | 1548879026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10820) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 40673) |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2026-06-18 |