| NPI | 1316321409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 1255) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PR 1255) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PR 1255) | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |