| NPI | 1982168589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 11864) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: ND 567) |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2022-08-17 |