| NPI | 1649096199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 5562) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI 2168) |
| 103T00000X Psychologist (Licence: HI 2168) | |
| 103T00000X Psychologist (Licence: AZ 5562) | |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2025-12-12 |