| NPI | 1396961504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810004382) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: VA 0803000074) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2011-03-07 |