| NPI | 1346381795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MI 6301012213) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301012213) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MI 6301012213) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2007-07-08 |