| NPI | 1154448215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO 01195) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 01195) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2022-09-15 |