NPI | 1265813844 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY11236) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY11236) |
Enumeration Date | 2015-06-09 |
Last Update Date | 2023-07-03 |