| NPI | 1063617983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC #0863) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NC #0863) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC #0863) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC #0863) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2007-07-08 |