| NPI | 1760704738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: LA 1356) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071.007783) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2017-05-16 |