| NPI | 1053929950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY10910) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2021-03-30 |