| NPI | 1558440412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY 129684) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IN 20041653A) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-10-27 |