| NPI | 1003914219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KS 1360) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO 2005032299) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-07-21 |