| NPI | 1558609727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-005159) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 4581) |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2019-10-15 |