| NPI | 1578602801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OK 1066) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OK 1066) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2015-04-09 |