| NPI | 1457415234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS017240) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: PA PS017240) |
| 103TC0700X Psychologist Clinical (Licence: PA PS017240) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2018-04-02 |