| NPI | 1053430470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ND 2086) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 2086) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC 2086) | |
| 103T00000X Psychologist (Licence: NC 2086) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NC 2086) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |