| NPI | 1659015691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO 2024005609) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KS LP03381) |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2025-12-23 |