| NPI | 1063769586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 22215) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OR 2630) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2024-01-26 |