| NPI | 1336440031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 00902) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: IA 00902) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IA 00902) | |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2010-11-11 |