| NPI | 1740739069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9205) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 05565) |
| 103TC0700X Psychologist, Clinical (Licence: NE 782) | |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-12-16 |