| NPI | 1619609096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071010781) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: IN 200043270) |
| 103TH0100X Psychologist Health Service (Licence: NC 5412) | |
| Enumeration Date | 2022-06-25 |
| Last Update Date | 2022-06-25 |