| NPI | 1730450107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2883) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY8466) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY8466) | |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2019-11-08 |