| NPI | 1043371891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VT 80416) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071-007011) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: UT 7805018-2501) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2014-10-06 |