| NPI | 1396236055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist Health Service (Licence: NC 5339) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 5339) |
| 103TC1900X Psychologist Counseling (Licence: NC 5339) | |
| 103TF0000X Psychologist Family (Licence: NC 5339) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: NC 5339) | |
| 103TS0200X Psychologist School (Licence: NC 5339) | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |