| NPI | 1699264275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 285496) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP6552) |
| 103TC0700X Psychologist, Clinical (Licence: WI 3854-57) | |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2025-08-27 |