| NPI | 1972915379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MO 2014016577) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 36586) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2024-10-03 |