| NPI | 1619428950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2746) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OR 2742) |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2020-11-11 |