| NPI | 1649426917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 1242) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS017113) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2013-07-01 |