| NPI | 1144728346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 37894) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 37894) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WV 1169) | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2020-07-22 |