| NPI | 1649303686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO PY01679) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO PY01679) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2008-08-31 |