| NPI | 1710600655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 293952) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2022033532) |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2025-01-30 |