| NPI | 1669087730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2024045766) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KS 03147-T) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2025-08-13 |