| NPI | 1326137993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: DE B100000897) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS004522L) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2012-12-11 |