| NPI | 1184970642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 8073852-2501) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MS 53926) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MS 53926) | |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2025-06-02 |