| NPI | 1073862405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY10721) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2016043860) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2021-03-29 |