| NPI | 1093195372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TN 2228) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: TN 2228) |
| 103TC0700X Psychologist Clinical (Licence: TN 2228) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2018-10-12 |