| NPI | 1720657547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 6572) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC 6572) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: SC 1680) | |
| 103T00000X Psychologist | |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2024-10-28 |