| NPI | 1639226061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 3425) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 3425) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2017-01-20 |