| NPI | 1902564735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 266182) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20043474A) |
| Enumeration Date | 2021-11-29 |
| Last Update Date | 2022-01-04 |