| NPI | 1558486647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SD 535) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0003913) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2016-06-27 |