| NPI | 1679879803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WY 658) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO PY 3275) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY 8062) | |
| Enumeration Date | 2011-02-05 |
| Last Update Date | 2020-03-16 |