| NPI | 1518402700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY9762) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2020-03-20 |