| NPI | 1295292514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 001879) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CT 001879) |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0000X Psychologist Family | |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2019-02-22 |