| NPI | 1124127618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MS 36648) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MS 36648) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MS 36-648) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-10-25 |