| NPI | 1679131221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE B1-0001177) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS018740) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |