| NPI | 1497172704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VT 48.011981) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2023-01-27 |