| NPI | 1356461933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0810007290) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OR 2343) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OR 2343) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-08-08 |