| NPI | 1891128062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 28410) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 24252) |
| 103TC0700X Psychologist Clinical (Licence: NY 24252) | |
| 103TC0700X Psychologist Clinical (Licence: TX 37232) | |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2023-01-31 |