| NPI | 1629196712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NM 1386) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY21810) |
| 103TC0700X Psychologist, Clinical (Licence: NM 1386) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2016-03-03 |