| NPI | 1083882799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 4597) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: GA PSY003120) |
| 103TC0700X Psychologist, Clinical (Licence: GA PSY003120) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY003120) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 4597) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 4597) | |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2016-02-22 |