| NPI | 1053805325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 4975) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-06-19 |