| NPI | 1568915932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05710) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 05710) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MD 05710) | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-08-02 |