| NPI | 1619320595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 849) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 849) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-07-15 |