| NPI | 1790327393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS019929) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: DE B1-0001204) |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2024-08-21 |