| NPI | 1306077979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 4019) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 24509) |
| 103TS0200X Psychologist, School (Licence: TX 30425) | |
| 103TS0200X Psychologist, School (Licence: AZ 3474589) | |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2009-07-31 |