| NPI | 1033573779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: LA 1079) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: LA 1079) |
| 103TS0200X Psychologist, School (Licence: LA 1079) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2016-04-08 |