| NPI | 1306176490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: 3845) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NC 3845) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: 3845) | |
| 103TC0700X Psychologist Clinical (Licence: NC 3845) | |
| 103TF0000X Psychologist Family (Licence: NC 3845) | |
| 103TS0200X Psychologist School (Licence: NC 3845) | |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2013-07-19 |