| NPI | 1205368206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TS0200X Psychologist, School | |
| 251S00000X | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2022-10-10 |