| NPI | 1467860841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CO 012720) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: CO 0318720) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-08-01 |