| NPI | 1619356763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 9547) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2016-05-18 |