| NPI | 1639780539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 40517) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 8076) |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2024-12-27 |