| NPI | 1609105188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810004632) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: VA 0810004632) | |
| 103TF0000X Psychologist Family (Licence: VA 0810004632) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: VA 0810004632) | |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2020-07-03 |