| NPI | 1629487053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05908) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC 1001207) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2016-12-09 |