| NPI | 1790814598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OK 1193) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 4868) |
| 103T00000X Psychologist (Licence: OK 1193) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-24 |