| NPI | 1356625081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO 2022015232) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2022015232) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2024-04-10 |