| NPI | 1629262316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 001144) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2017-12-21 |