| NPI | 1134755630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY31765) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: RI PS01787) |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-04-13 |