| NPI | 1578650313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 874) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-08-22 |