| NPI | 1043254428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 3235) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: IN 20041985) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2015-06-16 |