| NPI | 1891049425 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC psy1000791)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 05254)  | 
| 103TC0700X Psychologist, Clinical (Licence: VA 0810004490)  | |
| Enumeration Date | 2012-11-05 | 
| Last Update Date | 2019-08-22 |