| NPI | 1912316407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2772) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 10465) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2016-12-20 |