| NPI | 1184910911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SD 532) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: SD 532) |
| 103T00000X Psychologist | |
| 103TC1900X Psychologist Counseling (Licence: SD 532) | |
| 103TS0200X Psychologist School | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2015-06-09 |