| NPI | 1235413717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: AL 1715) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AL 1715) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2012-12-01 |