| NPI | 1417216615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CT 03-296526) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CT 03-296526) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2012-05-08 |