| NPI | 1225014723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3101) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NC 3101) |
| 103TH0100X Psychologist Health Service (Licence: NC 3101) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 3101) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2016-07-11 |