| NPI | 1366098741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 11200) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2019-11-19 |