| NPI | 1205230018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |