| NPI | 1720431851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3578) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA In Progress) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2020-01-27 |