| NPI | 1790830719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810002924) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 6750) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2025-09-28 |