| NPI | 1477959989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: PA PS017670) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS017670) |
| 103TS0200X Psychologist School (Licence: PA PS017670) | |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2015-11-23 |