| NPI | 1609426352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9992) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY004197) |
| Enumeration Date | 2019-09-15 |
| Last Update Date | 2021-12-21 |