| NPI | 1700902764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: AZ 3663) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: AZ 3663) |
| 103TR0400X Psychologist, Rehabilitation (Licence: AZ 3663) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2024-06-12 |