| NPI | 1811262439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 7163) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ID PSY-203095) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2025-09-23 |