| NPI | 1811552565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5709) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NC 103317) |
| 103TC1900X Psychologist, Counseling (Licence: NC 5709) | |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2021-04-15 |