| NPI | 1104442961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO PSY.005878) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2022-09-07 |