| NPI | 1720363674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NH 1306) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS017099) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2014-04-21 |