| NPI | 1598273203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: LA 1336) |
| Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy (Licence: LA 1336) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: LA 1336) | |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2018-01-16 |