| NPI | 1619181815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0000X Psychologist, Family (Licence: AZ 3233) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 3233) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 3233) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2010-04-12 |