| NPI | 1457415796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: DE B10001031) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OR 2932) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2016-03-17 |