| NPI | 1942563507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS 55980) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: LA 1643) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2024-05-03 |