| NPI | 1366090078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL xxxxxxxxx) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL xxxxxxxxx) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-09-06 |