| NPI | 1366821167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810005598) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| 103TF0000X Psychologist Family | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2016-12-27 |