| NPI | 1679798763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WI 2411-057) |
| 103TH0100X Psychologist, Health Service | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2025-09-11 |