| NPI | 1699873950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: PR 14078) |
| Additional Taxonomies | 273R00000X Psychiatric Unit (Licence: PR 14078) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-08 |