| NPI | 1801543954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 06417) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810007393) |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2022-03-08 |