| NPI | 1750424313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8005) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 8005) |
| 103TH0100X Psychologist, Health Service (Licence: MA 8005) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-04-03 |