| NPI | 1629629621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 38547) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY004328) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2020-11-02 |