| NPI | 1376847483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: SC 3753) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: SC 3753) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: SC 3753) | |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2011-01-04 |