| NPI | 1255627279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 3519) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: RI PS01245) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2017-10-27 |