| NPI | 1235657701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 6627) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: WV 46326) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2024-12-10 |