| NPI | 1104496686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ PSY-004988) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: AZ PSY-004988) |
| 103TS0200X Psychologist School (Licence: AZ PSY-004988) | |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2023-11-08 |