| NPI | 1588177943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006139) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 5895) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2019-11-13 |