| NPI | 1649670415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 37734) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 2567) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2018-03-12 |