| NPI | 1205834488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TN 2314) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TN 2314) |
| 103TC0700X Psychologist Clinical (Licence: TN 2314) | |
| 103TC1900X Psychologist Counseling (Licence: TN 2314) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2024-05-28 |