| NPI | 1720335417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 4299) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 4299) |
| 103TC1900X Psychologist Counseling (Licence: NC 4299) | |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2019-05-06 |