| NPI | 1558451120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 4107) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: AR 02-12P) |
| 103TC0700X Psychologist, Clinical (Licence: AR 02-12P) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: AR 02-12P) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-09-25 |