| NPI | 1598476640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA Psy32438) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 024083) |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2022-12-09 |