| NPI | 1073978979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: KS 2784) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MD 05470) |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2025-07-28 |