| NPI | 1154796480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NC 4882) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 4882) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2020-12-22 |