| NPI | 1427261155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 8963) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS015476) |
| 103TC0700X Psychologist, Clinical (Licence: PA PS015476) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS015476) | |
| 103TC0700X Psychologist, Clinical (Licence: MA 8963) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 8963) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2009-04-01 |