| NPI | 1124790217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| 103TH0004X Psychologist Health | |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-09-28 |