| NPI | 1699293837 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 2378)  | 
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: CO 117246)  | 
| Enumeration Date | 2017-09-08 | 
| Last Update Date | 2017-09-08 |