| NPI | 1962911875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL 9996) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: FL 9996) |
| 103TH0100X Psychologist Health Service (Licence: FL 9996) | |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2017-09-22 |