| NPI | 1962419028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5315) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 6977) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-04-25 |