| NPI | 1275916538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: DE B10001117) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10554) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2017-10-17 |