| NPI | 1538197686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: SC 766) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: SC 766) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY6270) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2020-10-22 |