| NPI | 1598993958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NE 1030) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KS T-LMLP 1279) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2020-10-19 |