| NPI | 1619389855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO PSY.0005719) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY29754) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2022-02-03 |