| NPI | 1568008860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA TPS030547) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WV 1176) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-21 |