| NPI | 1053781567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: AL 1966) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AL 1966) |
| 103TH0100X Psychologist Health Service (Licence: AL 1966) | |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2022-12-21 |