| NPI | 1003395294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 3356) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CT 3356) |
| 103TS0200X Psychologist, School (Licence: CT 3356) | |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-08-09 |