| NPI | 1316085954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2007-02-04 |
| Last Update Date | 2007-07-08 |