| NPI | 1629108022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MD 04196) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 04196) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2022-08-02 |