| NPI | 1982097127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: UT 102501922501) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4602) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2023-08-09 |