| NPI | 1982056008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11920) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 5061) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2023-05-05 |