| NPI | 1457375495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 1532) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 1532) |
| 103TS0200X Psychologist, School (Licence: NC 1532) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2014-01-14 |