| NPI | 1538354998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 07388) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 8774) |
| 103TC0700X Psychologist, Clinical (Licence: MA 8774) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IA 07388) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2020-05-28 |