| NPI | 1801958566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 0004207) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CO 0130808) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2015-08-04 |