| NPI | 1346686748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 2380) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 2380) |
| 103T00000X Psychologist (Licence: OR 2380) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2013-05-13 |