| NPI | 1356604466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: SC 1318) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2024-04-15 |