| NPI | 1629413919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: LA 1229) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MS 52913) |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: MS 52913) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: MS 52913) | |
| 103TS0200X Psychologist School | |
| 103TS0200X Psychologist School (Licence: MS 52913) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |