| NPI | 1518850429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 3989) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 40022) |
| Enumeration Date | 2025-05-30 |
| Last Update Date | 2025-05-30 |