| NPI | 1710210331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3645) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSY0003645) |
| 103TC0700X Psychologist, Clinical (Licence: NM 1207) | |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2024-05-17 |