| NPI | 1639560378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810005135) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: DC PSY1000948) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |