| NPI | 1629514708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS018447) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TS0200X Psychologist School | |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2024-08-21 |