| NPI | 1811008105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AR 03-03E) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AR 03-3E) |
| 103T00000X Psychologist (Licence: AR 03-03F) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-06-10 |