| NPI | 1679902274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05051) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY9826) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2025-01-13 |