| NPI | 1942610084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5166) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY003720) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810005005) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2020-10-26 |