| NPI | 1245581040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 102990) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 102990) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2014-11-20 |