| NPI | 1770132821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 003856) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: CT 3856) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-11-22 |