| NPI | 1962780833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IA 001253) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: IA 001253) |
| 103TA0700X Psychologist Adult Development & Aging (Licence: IA 001253) | |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2024-06-21 |