| NPI | 1821870999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 40166) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 280926) |
| Enumeration Date | 2023-10-13 |
| Last Update Date | 2024-02-22 |