| NPI | 1053934612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 103TH0100X Psychologist Health Service |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2025-06-10 |