| NPI | 1770773459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MO 2007030009) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MO 2007030009) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MO 2007030009) | |
| 103TH0100X Psychologist Health Service (Licence: MO 2007030009) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MO 2007030009) | |
| 103TR0400X Psychologist Rehabilitation (Licence: MO 2007030009) | |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2023-03-01 |