| NPI | 1750718011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1479) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 37666) |
| 103TC0700X Psychologist, Clinical (Licence: LA 0000) | |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2021-03-02 |