| NPI | 1073790416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MT 1953) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WY 750) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 6919) | |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2024-10-29 |