| NPI | 1689344350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY 271923) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IN 20043520A) |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-10-01 |