| NPI | 1720138019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OR 3201) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-06-28 |