| NPI | 1841516572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 39182) |
| Additional Taxonomies | 103T00000X Psychologist |
| 225100000X Physical Therapist (Licence: OR 5787) | |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2023-10-30 |