| NPI | 1679531040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4417) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: NC 4417) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL 8936) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-09-28 |