NPI | 1265776942 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS016555) |
Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: PA PS016555) |
103TS0200X Psychologist, School (Licence: PA PS016555) | |
Enumeration Date | 2012-11-19 |
Last Update Date | 2019-04-24 |