| NPI | 1780239616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 06705) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: VA 081007401) | |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2021-10-15 |