| NPI | 1912391921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN P1927) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VT 048.0088564) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-03-27 |