| NPI | 1720891658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810008776) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY12444) |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-05-13 |