| NPI | 1609159821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810004463) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TN 3401) |
| 103TC0700X Psychologist, Clinical (Licence: TN 3401) | |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2022-01-19 |