| NPI | 1558724328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 06291) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS018018) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2022-08-04 |