| NPI | 1568785582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11294) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: LA 1214) |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2022-06-25 |