| NPI | 1861901209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 4604) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 2117) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2025-03-13 |