| NPI | 1245378421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: LA 1166) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: LA 1166) |
| 103TF0000X Psychologist Family (Licence: LA 1166) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2011-11-16 |