| NPI | 1588715379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2766) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OR 2766) |
| 103TF0000X Psychologist Family (Licence: OR 2766) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2024-09-17 |