| NPI | 1962188144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 5041-57) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 3665) |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2024-11-18 |