| NPI | 1508167560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 4139) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 4139) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2023-04-22 |