| NPI | 1942604061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10014) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MS 53 922) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-18 |