| NPI | 1639650716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY11012) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PR 2479) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2024-01-09 |