| NPI | 1699293183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9944) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA PSY11497) |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2024-12-23 |