| NPI | 1093149031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: DC 1001034) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 05061) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2016-09-07 |