| NPI | 1760425839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IA 092634) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AL 1225) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2018-10-12 |