| NPI | 1629695952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 2210) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AL 2210) | |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2021-05-26 |