| NPI | 1093196487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2770) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 2770) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2021-01-18 |