| NPI | 1891121778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5056) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS017126) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2016-09-21 |