| NPI | 1659881043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 3456-57) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 3456) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2021-01-20 |