| NPI | 1215111646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 3836) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist (Licence: NC 3836) | |
| 103TF0000X Psychologist, Family (Licence: NC 3836) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC 3836) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 3836) | |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2010-02-24 |