| NPI | 1679893630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NM 1205) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 3527) |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2023-06-08 |