| NPI | 1194966093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 4696) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: HI 1089) |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2021-11-10 |