| NPI | 1699240572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5351) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004828) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 5351) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810004828) | |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |