| NPI | 1861964207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 1545) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KS 2663) |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2024-03-04 |