| NPI | 1053985853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO 2026030832) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: RI PS02276) |
| 101Y00000X Counselor (Licence: NE 12558) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KS LP03563) | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2026-08-04 |