| NPI | 1740266220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4748) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 2551) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2022-04-13 |