| NPI | 1700810132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN 3162) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810003415) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-04-26 |