| NPI | 1346260932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OR 2260) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 8599) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WA PY60221263) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2016-12-20 |