| NPI | 1366441933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 022757) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 022757) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 022757) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2010-08-30 |