| NPI | 1689707903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: CO 2903) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: CO 2903) |
| 103TC0700X Psychologist Clinical (Licence: CO 2903) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CO 2903) | |
| 103TH0100X Psychologist Health Service (Licence: CO 2903) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2011-09-13 |