| NPI | 1720611833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC 1609) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 5867) |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2023-04-06 |