| NPI | 1518392828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY9003) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP5640) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2018-04-13 |