| NPI | 1811245277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS 50875) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 4243) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2016-06-14 |