| NPI | 1265590418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 3783) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: AZ 3783) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 3783) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2022-02-03 |