| NPI | 1518277680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 4262) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4262) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: AZ 4262) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: AZ 4262) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: AZ 4262) | |
| 103TS0200X Psychologist School (Licence: AZ 4262) | |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2020-07-29 |