| NPI | 1306371786 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3594) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 3594) | |
| Enumeration Date | 2017-04-24 | 
| Last Update Date | 2023-04-24 |