| NPI | 1861801938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NE 949) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KS 2548) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2017-11-06 |