| NPI | 1912635475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 06858) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 06858) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 06858) | |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2022-08-11 |