| NPI | 1881754398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8621) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 8621) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-03-07 |