| NPI | 1306007992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CO PSY3459) |
| Additional Taxonomies | 103TF0000X Psychologist Family (Licence: CO PSY3459) |
| 103TR0400X Psychologist Rehabilitation (Licence: CO PSY3459) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2014-10-29 |