| NPI | 1144331612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA 009110L) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: PA 009110L) |
| 103TC0700X Psychologist, Clinical (Licence: PA 009110L) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PA 009110L) | |
| 103T00000X Psychologist (Licence: PA 009110L) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-01-17 |