| NPI | 1164912820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 11460) |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2019-10-04 |