| NPI | 1578642385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN P2738) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN 2738temporary) |
| 103TC0700X Psychologist, Clinical (Licence: MS 45737MS) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2017-11-29 |