| NPI | 1235111675 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: AZ 3783803) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW013180) | 
| Enumeration Date | 2005-11-18 | 
| Last Update Date | 2025-09-11 |