| NPI | 1669572202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AR 06-27P) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: AR 06-27P) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2009-10-16 |