| NPI | 1679550065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: SD 479) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP4419) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2024-04-15 |