| NPI | 1619287752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NV PYP101310) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY3610) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810004996) | |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2016-09-12 |