| NPI | 1366822652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 4913) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2018-03-17 |