| NPI | 1720699739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3514) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103T00000X Psychologist (Licence: OR 3514) | |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2022-11-01 |