| NPI | 1659005551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL PY10939) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL 10939) |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2022-08-18 |