| 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, Intellectual & Developmental Disabilities (Licence: NC 5339)  | |
| 103TS0200X Psychologist, School (Licence: NC 5339)  | |
| Enumeration Date | 2018-05-29 | 
| Last Update Date | 2018-05-29 |