| NPI | 1912455866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MO 2016034053) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MO 2016034053) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2025-03-27 |