| NPI | 1821612144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5589) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810006122) |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2022-04-04 |