| NPI | 1902017114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: LA 321261) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NM 1431) |
| 103TC1900X Psychologist, Counseling (Licence: VA 0810000245) | |
| 103TF0200X Psychologist, Forensic (Licence: VA 0810000245) | |
| 103TP0016X Psychologist, Prescribing (Medical) (Licence: NM PSY-RXP0058) | |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2022-11-15 |