| NPI | 1164615456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4338) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20042197A) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 20042197) | |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2012-11-28 |