| NPI | 1578939724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY9371) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: RI PS01510) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2018-02-21 |