| NPI | 1861825465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5252) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 4765) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2020-08-13 |