| NPI | 1801887591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS 33520) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN P00001796) |
| 103TC0700X Psychologist, Clinical (Licence: AR 93-32P) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2007-07-08 |