| NPI | 1669913810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 3643) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CT 003987) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2023-09-06 |