| NPI | 1265690614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810004184) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: VA 0810004184) |
| Enumeration Date | 2008-06-01 |
| Last Update Date | 2010-08-18 |