| NPI | 1598099459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 5349) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 10409) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2021-06-29 |