| NPI | 1740752435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY10558) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: TX 38097) |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2025-05-23 |