| NPI | 1104247675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 2-3049) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 6165) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2013-12-30 |